Advance Directive Registries

A recent DHHS study reported that "between 65% and 76% of physicians whose patients had an AD were unaware of its existence."  This lack of availability exacerbates the already too-low completion rate.  One way to address the availability issue is through AD registries.  In a forthcoming article titled “The Advance Directive Registry or Lockbox: A Model Proposal and Call to Legislative Action.”in the JOURNAL OF LEGISLATION, Capital Law School Professor Joseph Karl Grant reviews and evaluates registry legislation.  Here is the abstract: 

In times of need, what portal or place could we go to easily retrieve a person’s advance directives when we have need to employ and use them? Well, a handful of states have come up with a solution. Nevada, Washington, and Vermont now have legislation in place that allows citizen’s of those states to digitally or electronically store their advance directives on the Internet, in a digital or electronic lockbox or portal of sorts. These states have addressed a critical need of their citizens: the need to have their advance directives accessible and readily available to health care providers so that their intent and wishes will be honored. 

This Article advocates that other states follow the lead of Nevada, Washington, and Vermont by adopting similar legislation and embracing digital or electronic technology by creating Internet “lockboxes” or registries, or portals where citizens can store their advance directives, and health care providers can access these advance directives in the most pressing and critical situations. 

Part One of this Article examines the rationale and need driving the creation of digital or electronic registries. Part Two of this Article lays out a model for the movement toward an advance directive for health care registry. Specifically, Part Two examines some of the pitfalls and shortcomings in existing legislation in Nevada, Washington, and Vermont. Additionally, Part Two sets forth model legislation that could be adopted by states wishing to legislatively create an advance directive for health care registry. Part Three explores who could administratively administer an advance directive for health care registry in the various states that decide to adopt the model legislation. Part Four addresses mechanisms and means to create the website or portal. Part Five explores the cost and expenses involved in building and maintaining the website or portal. Part Six explores demographic issues, namely who will use and benefit from an advance directive for health care registry.